CAJ | 학술논문

目的：探讨脂类物质对循环酶法测定血清总胆汁酸（TBA）的干扰和试剂可能携带的污染，寻找减少和消除干扰和污染的方法。方法采用循环酶法测定血清 TBA，观察高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、胆固醇（TC）、三酰甘油（TG）试剂对 TBA 检测的携带污染，以及高血脂样本对 TBA 检测的干扰，并尝试通过设置不同的冲洗程序和检测顺序来减少对 TBA 的干扰和携带污染。结果用低值和高值混合血清进行 TBA 检测，研究结果表明，在检测 TBA 前后清洗过程中，用水做冲洗液比酸性洗液做冲洗液，血清 TBA 检测结果的准确更高，设置清洗和不设置清洗对检测结果的影响显著（P ＜0．01）。以脂类试剂为样品重复检测其 TBA 浓度，取均值，发现 HDL-C 对 TBA 检测稳定性的影响最大[（476．06±1．88）μmol/L]，其次是 TC 和 TG，分别为[（127．78±1．18）、（121．05±1．08）μmol/L]，而 LDL-C 影响最小[（2．23±0．51）μmol/L]。干扰 TBA 检测结果稳定性的严重程度由大到小依次为 HDL-C、TC、TG 和 LDL-C。设置检测顺序，冲洗程序。再用多干扰项目混合样本/TBA，结果表明血脂样本对 TBA 的干扰大大降低（P ＜0．01），但是不能完全排除干扰。结论生化分析仪的分析顺序和冲洗程序以及试剂成分的外源性物质干扰严重影响测定结果的准确性。要想保证结果准确、可靠，不但需要设置合理的冲洗和反应顺序，还要熟练掌握仪器操作和项目的反应原理，了解试剂的成分，更加要掌握仪器的定期维护和保养等方面的知识。
목적：탐토지류물질대순배매법측정혈청총담즙산（TBA）적간우화시제가능휴대적오염，심조감소화소제간우화오염적방법。방법채용순배매법측정혈청 TBA，관찰고밀도지단백담고순（HDL-C）、저밀도지단백담고순（LDL-C）、담고순（TC）、삼선감유（TG）시제대 TBA 검측적휴대오염，이급고혈지양본대 TBA 검측적간우，병상시통과설치불동적충세정서화검측순서래감소대 TBA 적간우화휴대오염。결과용저치화고치혼합혈청진행 TBA 검측，연구결과표명，재검측 TBA 전후청세과정중，용수주충세액비산성세액주충세액，혈청 TBA 검측결과적준학경고，설치청세화불설치청세대검측결과적영향현저（P ＜0．01）。이지류시제위양품중복검측기 TBA 농도，취균치，발현 HDL-C 대 TBA 검측은정성적영향최대[（476．06±1．88）μmol/L]，기차시 TC 화 TG，분별위[（127．78±1．18）、（121．05±1．08）μmol/L]，이 LDL-C 영향최소[（2．23±0．51）μmol/L]。간우 TBA 검측결과은정성적엄중정도유대도소의차위 HDL-C、TC、TG 화 LDL-C。설치검측순서，충세정서。재용다간우항목혼합양본/TBA，결과표명혈지양본대 TBA 적간우대대강저（P ＜0．01），단시불능완전배제간우。결론생화분석의적분석순서화충세정서이급시제성분적외원성물질간우엄중영향측정결과적준학성。요상보증결과준학、가고，불단수요설치합리적충세화반응순서，환요숙련장악의기조작화항목적반응원리，료해시제적성분，경가요장악의기적정기유호화보양등방면적지식。
Objective To investigate whether lipids and reagents would interfere the results when serum total bile acid(TBA) was measured by enzymatic cycling assay.Methods The serum TBA was measured by enzymatic cycling assay.The carry-over contaminations of high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),cholesterol(TC),and triglyceride(TG)rea-gents were evaluated.In order to reduce the interference and carry-over contaminations,different washing procedures and detection sequence were set.Results By measuring the levels of TBA in pooled serums with low and high levels of lipids,the results showed that there was statistically significant difference between the groups with and without the addition of cleaning process before and af-ter TBA measurement(P <0.01).Cleaning with water might be more effective on reducing interference than those with acid solu-tion.Moreover,the mean of TBA levels in HDL-C,TC,TG and LDL-C reagents were (476.06 ± 1.88 ),(127.78 ± 1.18 ), (121.05±1.08),and (2.23±0.51)μmol/L,respectively.The stability of TBA level was greatly affected by HDL-C regents,fol-lowing by TC and TG reagents,and was little affected by LDL-C reagent.Setting up proper detection sequence and flushing proce-dures could obviously reduce the interference(P <0.01),but not completely rule out.Conclusion Analysis sequence and flushing procedures of biochemical analyzer as well as exogenous substance from reagents may seriously affect the accuracy of determination results.To ensure the accuracy and reliability of the results,it is necessary not only to set up reasonable irrigation and reaction se-quence,but also to master the instrument operation,to know the principle of test reaction and the components of reagents as well as equipment maintenance.